A lack of a good night’s sleep can affect not only the child but the entire family. Generally, babies in their early months are eased into a normal cycle of sleep and wakefulness while reducing the number of daytime naps and sleeping for a longer duration at night. However, some autistic children face problems sleeping through the night. This problem can persist and may not go away with age. In such cases, lifestyle interventions for a sleep aid for an autistic child are needed to minimize or solve this problem.
What Does Research Say About Autism and Sleep Issues?
“Autism” or Autism Spectrum Disorder or simply ASD, is a condition of early childhood that leads to a disorder that affects the overall neurodevelopmental including cognitive, social, emotional and physical health of an individual. It commonly results in symptoms like difficulty in reading, obsessive interests, repetitive behaviour, and inability to communicate or social interaction with others. As per “Autism Speaks”, an organization that works towards educating the public about autism, the severity of the issues with learning, thinking, and solving problems can vary from one person to the other.
Many autistic people are highly skilled and can lead an independent life, while there are others who would need a high level of care and assistance on a daily basis. Epilepsy, anxiety, chronic sleep deficit and gastrointestinal problems are a few of the associated health problems experienced by those on the autism spectrum. Several research reports, including one published by the “American Academy of Paediatrics”, indicate that sleeping difficulty is experienced by children with some types of autism. These problems can include difficulty in getting sleep, frequent waking up due to nightmares, bedwetting, snoring, restlessness or poor sleep quality, inconsistent sleep routines and shorter overall sleeping time. As per the results of a longitudinal neuroimaging study published in “American Journal of Psychiatry”, autism and sleep in babies are related.
Infants experiencing sleep onset problems in their first year of life have a higher probability of getting diagnosed with autism later. “University of Pennsylvania’ conducted a study at their “Centre for Sleep and Circadian Neurobiology” and concluded that significant behavioural and learning problems or daytime irritability results from autism and sleep disorders in children. Thus, if you are one of those parents wondering how to get an autistic child to sleep, it is always beneficial to take professional help to understand the issues and take remedial steps required to help the child.
Reasons for Sleep Issues in Autism
As per numerous studies evaluated by researchers, there is a causative link between autism and sleeping disorder, therefore, requiring comprehensive behavioural insight. The severity of the problem with the ability to sleep varies depending on the range of autism spectrum disorder. A thorough understanding of the underlying reasons for your child’s sleep problem can make it easier for helping an autistic child sleep or lessening the problems through appropriate treatments. Here are a few possible theories that might throw light on the reasons:
Genetic factors of autism may have directly impaired the ability of the child to fall asleep, remain asleep, and wake up refreshed.
2. Sensory sensitivity
Most children with autism have difficulty in sleeping because of their increased sensitivity to outside stimuli, such as touch or sound, leading to a disturbed rest.
3. Reduced levels of Melatonin
Normally, melatonin levels rise in response to night darkness and fall during the daylight hours. Some of the studies suggest that kids with autism produce lower levels of melatonin at night time, affecting their ability to sleep.
4. Other physical or mental health conditions
ADHD, seizure disorders, obsessive-compulsive disorder, anxiety and acid refluxes are some of the illnesses and mental conditions associated with autism that can make it harder to get sleep. Kids who bed wet and struggle with toilet training wake up several times at night. Cold or ear infections can also aggravate during the night, which disrupts a child’s bedtime routine. Moreover, severe other medical conditions like asthma and epilepsy can also make it hard for them to settle down or sleep well.
5. Sleep apnea
Sleep apnea is a condition in which a person misses breath several times while sleeping. Snoring is a sign of sleep apnea. When less oxygen is delivered to the brain, it can cause less restful sleep, fatigue and headaches that can hinder brain development. Apart from physical damage, the effects of sleep apnea can contribute to worsening behavioural symptoms like irritability and excitability during daytime activities.
6. Change in routine
Autistic children and adolescents often have intense interests that make up their consistent daily routine. Any disruptions to this schedule due to external causes can be greatly disturbing and may cause enough anxiety to affect their sleep.
7. Daytime and bedtime habits
Unhealthy eating habits and a sedentary lifestyle can cause sleeplessness in most people, more so for autistic children. Consumption of caffeine or any sugary drinks in the evening causes a spike in blood sugar levels that make children get too excited when it’s time to hit the bed. Irregular mealtimes and going to bed feeling too hungry can cause sleeplessness. Long and late daytime naps for children aged over five years makes it difficult to fall asleep at night. Electronic gadgets like television, video games or the internet that stimulate the senses can also cause sleeplessness.
8. Social cues
People usually know when it’s time to go to sleep at night due to the circadian rhythms (the normal cycles of light and dark) of the body. However, children diagnosed with ASD have difficulty understanding, often misinterpreting, or unable to catch the social cues when they see their siblings getting ready for bed.
How Do Sleep Problems Affect a Child With Autism?
Sleeplessness can have a serious impact on a child’s life and overall health. Lack of sleep makes children in general cranky and prone to tantrums. In a child with autism, poor nighttime sleep leads to aggression, depression, hyperactivity, verbal and non-verbal impairments, increased behavioural deficits, lower intelligence, irritability, poor learning and cognitive performance, as well as lack of motor development.
Some Effective Techniques for Improving Sleep in an Autistic Child
It can be really hard for families to comprehend how sleep and ASD are interconnected, thereby sometimes leaving the issue untreated. Sleep problems related to ASD can be treated through autism and sleep problems advice or reduced through autism sleep medication and simple lifestyle and behavioural changes. Sure enough, it might take time for a child to establish a healthy, positive sleeping routine, but in the long run, it is definitely worth the effort. After all, a good night’s sleep can negate the chances of developing severe sleep-related conditions and help them deal with autism much better. Children of any age group need the care of a loving family for their well-being. So let us look into some of the positive actions that can improve sleep in an autistic child as per the guidelines of researchers.
1. Establish good sleeping hygiene
A properly established and regular bedtime routine that starts at least an hour ahead of time helps children sleep better at night. First, create a calm atmosphere for making a clear, repetitive routine. A warm relaxing bath, changing into their nightdress, brushing their teeth and doing activities like reading, listening to soft music, drawing, a gentle oil massage or any other activity to soothe children before is going to act as an enabler for a good night’s sleep. Some children respond well to a snack before bedtime. Many children with autism are emotionally attached to their favourite stuffed toys that can be tucked into their bed for cuddling during sleep. Stick with the routine if possible even during vacations and weekends and put them to bed at the same time on all nights.
2. Quiet bedroom ambience
The sleeping environment should be as pleasant and comfortable as possible, which should be able to invite a sleepy mood. Keep your bedroom neutral, slightly cool and quiet to prevent any disturbances. Avoid sensory distractions like strong scent, taste, sound and touch that can act as triggers. Use dark coloured curtains for absolute blackout, install thick carpeting or ensure the doors don’t creek to avoid or to reduce sound to a minimum. Select bedding that fits your child’s sensory needs. Eye pillows and weighted quilts can also offer added comfort.
3. Visiting nature and exposure to the environment
Take help from a sleep psychologist about bright-light therapy. Exposing the child to periods of bright light in the morning may help regulate the body’s release of melatonin that helps them to stay awake longer during the day. Sunlight can also increase vitamin D levels, which can further improve sleep quality.
4. Transition from waking to sleeping hours
A bedtime routine or preparations for sleep should be predictable, not take too long and should be introduced gradually. Prepare them mentally at least 15, 10, and 5 minutes before it’s time to begin the bedtime routine. Switch off the TV or any other electronic gadgets. Visual timers or auditory alarms can be used to indicate the exact time to sleep.
5. Melatonin supplement
Research suggests that giving your child the dietary supplement melatonin just before bedtime helps in normalizing sleep-wake cycles in autistic children. Dietary supplements containing valerian root, iron, and multivitamins help to improve and strengthen the immune system of children with autism. While safe and effective, it is always prudent to ask your child’s paediatrician before starting any dietary supplement, as in some cases, they can cause dizziness, diarrhoea, and nausea.
6. Relaxation exercise
Children benefit greatly from doing mild exercises. Physical activity promotes serotonin, helps one to relax and fall asleep easily. It also lowers levels of stress and anxiety. The relaxation training could range from breathing techniques, muscle relaxation to even visualization exercises.
7. Balanced diet
Eating nutritious and balanced meals that include fresh fruits, leafy greens, and vegetables are essential to help the body and mind prepare for sleep. Fatty snacks, carbohydrate-rich food, sugary drinks, caffeine, or alcohol promotes wakefulness and bursts of energy can cause anxiety in children.
For children with autism, a peaceful and good night’s sleep is an elusive thing that can leave them feeling out of sync with the world around them. Parents should remember that every autistic child is different, and therefore a therapy that works for one child may not work in another. Keep trying until you find the solution that works best for your child.